IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i16p5963-d400078.html
   My bibliography  Save this article

Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study

Author

Listed:
  • Yanchen Liu

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Yingchun Chen

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Xueyan Cheng

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Yan Zhang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

Abstract

Excess healthcare utilization is rapidly rising in rural China. This study focused on excess outpatient demand (EOD) and aimed to measure its performance and sociodemographic determinants among China’s rural residents. A total of 1290 residents from four counties in central China were enrolled via multistage cluster random sampling. EOD is the condition in which the level of hospital a patient chooses is higher than the indicated level in the governmental guide. A multilevel logistic regression was used to examine the sociodemographic determinants of EOD. Residents with EOD accounted for 85.83%. The risk of EOD was 51.17% and value was 5.69. The value of EOD in diseases was higher than that in symptoms (t = −21.498, p < 0.001). Age (OR = 0.489), educational level (OR = 1.986) and hospital distance difference (OR = 0.259) were the main sociodemographic determinants of EOD. Excess outpatient demand was evident in rural China, but extreme conditions were rare. Results revealed that age, educational level and hospital distance were the main sociodemographic determinants of EOD. The capacity of primary healthcare institutions, universality of common disease judgement and understanding of institution’s scope of disease curing capabilities of residents should be improved to reduce EOD.

Suggested Citation

  • Yanchen Liu & Yingchun Chen & Xueyan Cheng & Yan Zhang, 2020. "Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(16), pages 1-14, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:16:p:5963-:d:400078
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/16/5963/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/16/5963/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2-3), pages 181-188, May.
    2. Dourgnon, Paul & Naiditch, Michel, 2010. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Health Policy, Elsevier, vol. 94(2), pages 129-134, February.
    3. Groenewegen, Peter P. & Dourgnon, Paul & Greß, Stefan & Jurgutis, Arnoldas & Willems, Sara, 2013. "Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries," Health Policy, Elsevier, vol. 113(1), pages 170-179.
    4. Xiaxia Sun & Hongdao Meng & Zhiqiu Ye & Kyaien O Conner & Zhanqi Duan & Danping Liu, 2019. "Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.
    5. Wenwei Liu & Suwei Yuan & Fengqin Wei & Jing Yang & Jin Ma, 2018. "Inappropriate admissions of the cardiology and orthopedics departments of a tertiary hospital in Shanghai, China," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-12, December.
    6. Agnus M. Kim & Seongcheol Cho & Hyun Joo Kim & Hyemin Jung & Min-Woo Jo & Jin Yong Lee & Sang Jun Eun, 2018. "Primary Care Patients’ Preference for Hospitals over Clinics in Korea," IJERPH, MDPI, vol. 15(6), pages 1-11, May.
    7. Rao, Krishna D. & Sheffel, Ashley, 2018. "Quality of clinical care and bypassing of primary health centers in India," Social Science & Medicine, Elsevier, vol. 207(C), pages 80-88.
    8. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2), pages 181-188.
    9. McClain, J.O. & Riedel, D.C., 1973. "Screening for utilization review: on the use of explicit criteria and non-physicians in case selection," American Journal of Public Health, American Public Health Association, vol. 63(3), pages 247-251.
    10. repec:dau:papers:123456789/12227 is not listed on IDEAS
    11. Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
    12. Suhang Song & Beibei Yuan & Luyu Zhang & Gang Cheng & Weiming Zhu & Zhiyuan Hou & Li He & Xiaochen Ma & Qingyue Meng, 2018. "Increased Inequalities in Health Resource and Access to Health Care in Rural China," IJERPH, MDPI, vol. 16(1), pages 1-10, December.
    13. repec:dau:papers:123456789/12226 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.
    2. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.
    3. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    4. Hao Zhang & Huimei Hu & Christina Wu & Hai Yu & Hengjin Dong, 2015. "Impact of China's Public Hospital Reform on Healthcare Expenditures and Utilization: A Case Study in ZJ Province," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
    5. Guanghui Jin & Yali Zhao & Chao Chen & Wenji Wang & Juan Du & Xiaoqin Lu, 2015. "The Length and Content of General Practice Consultation in Two Urban Districts of Beijing: A Preliminary Observation Study," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-10, August.
    6. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.
    7. Pan, Jay & Qin, Xuezheng & Li, Qian & Messina, Joseph P. & Delamater, Paul L., 2015. "Does hospital competition improve health care delivery in China?," China Economic Review, Elsevier, vol. 33(C), pages 179-199.
    8. Nóra Kovács & Anita Pálinkás & Valéria Sipos & Attila Nagy & Nouh Harsha & László Kőrösi & Magor Papp & Róza Ádány & Orsolya Varga & János Sándor, 2019. "Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study," IJERPH, MDPI, vol. 16(17), pages 1-15, August.
    9. Kok, Lucy & Boyle, Seán & Lammers, Marloes & Tempelman, Caren, 2015. "Remuneration of medical specialists. Drivers of the differences between six European countries," Health Policy, Elsevier, vol. 119(9), pages 1188-1196.
    10. Honora Smith & Christine Currie & Pornpimol Chaiwuttisak & Andreas Kyprianou, 2018. "Patient choice modelling: how do patients choose their hospitals?," Health Care Management Science, Springer, vol. 21(2), pages 259-268, June.
    11. A Jeong Kim & Hayeon Lee & Eun-Jeong Shin & Eun-Jung Cho & Yoon Sook Cho & Hajeong Lee & Ju-Yeun Lee, 2021. "Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy," IJERPH, MDPI, vol. 18(8), pages 1-8, April.
    12. Omelyanovsky, Vitaly (Омельяновский, Виталий) & Avxentieva, Maria (Авксентьева, Мария) & Zheleznyakova, Inna (Железнякова, Инна) & Ignatyeva, Victoria (Игнатьева, Виктория) & Tyurina, Irina (Тюрина, И, 2018. "Improving of the Systems of Organization and Payment of Ambulatory Medical Care [Совершенствование Систем Организации И Оплаты Амбулаторной Медицинской Помощи]," Working Papers 031807, Russian Presidential Academy of National Economy and Public Administration.
    13. Thierry Debrand & Christine Sorasith, 2010. "Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity," Working Papers DT34, IRDES institut for research and information in health economics, revised Nov 2010.
    14. Olivier Saint-Lary & Erik Bernard & Jonathan Sicsic & Isabelle Plu & Irène François-Purssell & Carine Franc, 2013. "Why Did Most French GPs Choose Not to Join the Voluntary National Pay-for-Performance Program?," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-7, September.
    15. Groenewegen, Peter P. & Dourgnon, Paul & Greß, Stefan & Jurgutis, Arnoldas & Willems, Sara, 2013. "Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries," Health Policy, Elsevier, vol. 113(1), pages 170-179.
    16. Sophie Massin & Antoine Nebout & Bruno Ventelou, 2018. "Predicting medical practices using various risk attitude measures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 843-860, July.
    17. Agnus M. Kim & Sungchan Kang & Jong Heon Park & Yoon Kim, 2020. "Regional Variation of Hospitalization Rates for Asthma in Korea: Association with Ambient Carbon Monoxide and Health Care Supply," IJERPH, MDPI, vol. 17(4), pages 1-10, February.
    18. Dourgnon, Paul, 2013. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/12221 edited by Wittwer, Jérôme.
    19. Damien Bricard & Zeynep Or, 2019. "Impact of early primary care follow-up after discharge on hospital readmissions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(4), pages 611-623, June.
    20. Cao, Wen-Rui & Huang, Qiu-Ru & Zhang, Nan & Liang, Hui-Juan & Xian, Ben-Song & Gan, Xiao-Fang & Xu, Dong Roman & Lai, Ying-Si, 2022. "Mapping the travel modes and acceptable travel time to primary healthcare institutions: A case study in Inner Mongolia Autonomous Region, China," Journal of Transport Geography, Elsevier, vol. 102(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:16:p:5963-:d:400078. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.